Top Docs - Bariatrics
Story and interview by Cathy Cassinos-Carr
LAURA L. MACHADO, M.D.
Specialty: Bariatric surgery, Sacramento Bariatric Medical Associates/Mercy San Juan Medical Center
Medical school: University of California, San Diego (La Jolla, Calif.)
Why bariatrics? Primarily because bariatrics is a very interesting field of surgery that can impact so many areas of a patient’s life. Not only the medical aspects, like putting diseases like diabetes into remission, but it can also have a profound effect on a person’s self-esteem.
You seem to have a real empathy for weight issues. I can really relate to my patients because I’ve been heavy myself and I know how your weight can impact all areas of your life. At my highest I weighed 238, and I now weigh about 160. I almost qualified for the surgery myself, but instead I followed the recommendations I give my patients to follow after surgery—protein supplements and a high protein, low carb diet.
What’s important to know about bariatric surgery? That it’s not a magic bullet that allows a patient to eat whatever they want. Part of what makes bariatrics different is the long-term monitoring—that’s really an important part of my work. Patients need the long-term support.
What do you say to the naysayers who say “These people don’t need surgery—they just need to eat less”? What I say to people like that is that it’s a very oversimplified way of looking at a very serious medical problem. If you had high blood pressure, you would have no hesitation taking BP meds because that’s the best treatment for it. And with many patients, surgery is the best treatment for obesity.
Do you think there will ever be a magic pill for weight loss? I think a magic pill is many, many, many years away, if at all possible. Obesity is a multifactorial disease, so what are you going to do, take a bag of pills every day so you’re not as hungry? It’s just not plausible.
On a lighter note, do you really use staples for stomach stapling surgery? (Laughs) Well, it’s not the office stapler—not at all. But we do use staples—surgical staples—in gastric bypass surgery to both seal and divide tissue.
Do you cringe when you see deep-fried Twinkies at the State Fair? Yes (laughs). It’s just, c’mon, do we really have to fry everything?